Guest guest Posted June 6, 2003 Report Share Posted June 6, 2003 wrote: > Sorry if I seem challenging to some of these issues, but they hit on > some fundamental concepts that I think need exploring, i.e. > classifying Chinese herbs within western terms for 1... Totally fine. I agree. And by the way, hi Jason! Hope things are going well for you in Colorado, is it? I appreciate all this discussion. I wanted to make the PULSE peer-reviewed, but honestly didn't expect much interest from CM experts. More on that below. > I actually don't think this is answered . a) YES san qi is said to > have a coagulate effect, although I think Bensky says that in vivo it > has no haemostatic properties in powdered form (from memory - someone > should re-check)... I'd be checking the dates of the research- does Bensky give dates for the research he quotes? Not in the text, but perhaps in the back? His source could be outdated. Did any other study back it up? > So yes san qi is in the FORMULA YNBY but is YNBY > a STRONG Coagulate??? This is not said anywhere to my knowledge. > Remember formulas are not individual herb properties... It has been > proven that many individual functions or (biochem constituents) are > changed when cooked or taken with other herbs. Good point- do you have a good example, or which HbF was proven to have different fxs from its constituents? I certainly accept that HbF's could have multiple vectors (of action), perhaps even opposite ones at the same time. Otherwise, they'd be just like drugs, or totally inactive. As I said before, I'd bet YNBY has some complex hemodynamics, and I'd love to see what they are, or have them explained to me. But, I just try to watch out for my assumptions- I don't assume that all HbF are superior to or more elegant than all drugs, e.g. > No I do not agree! there is much more going on here then 1 idea about > 1 herb (especially a western idea) - there is also a blood moving > component. I don't think it is that black & white. And again is there > source for that? Do we have any cases of strokes occurring with pre- > op surgery use? Or any other documented cases of other problems? The > article mentions generally herb problems but not specific YNBY, this > is why I said , why single YNBY out. As far as I know, all we know is: 1. Some CM docs think that YNBY provides for surprising healing 2. There is controversy about whether YNBY is safe before surgery 3. Adverse events do happen with surgery, but we do not have an airtight system of communication and recordkeeping about herbal use pre-surgery between CM docs and WM docs. So we cannot make correlations to see if YNBY might have caused strokes, clots, etc. We can only speculate. > Also I.e. just san qi also increases blood flow in the coronary > artery, dilation of vessels, decrease arterial pressure, heart rate, > oxy consumption etc etc. Source? >> We never studied the McLean book- we had >> Fratkin's. > > This brings an important point, I believe. First I think it is great > that you are going out there and helping educate people about CM. Thanks. > But let us look at something. I think if you are going to do a piece > on YNBY (or any other topic), you should really check the sources out > there making sure that you have all the info. I'd be happy to do that if I had all the books. At this time, I do not own a complete library. For example, I'd love to have the $170 pharmacology of herbs by kee huang, but I can't afford it. Nor does PCOM have it, nor can I get them to buy it. However, it you would like to complete my library, I'd be happy to accept donations ;-) In a perfect world, I would be able to write the perfect article before you saw it. But in the real world, we all need help, such as the input you are providing. Thanks! BTW, I will be revising those articles to include all this input. > I think you are > putting yourself out as expert on the subject- especially with many > of the BOLD statements made. But what if I had a patient and I gave > them YNBY post/pre surgery (as I did 4 weeks ago) and they did an > internet search and saw this article. And saw how you had never heard > of such a practice and how crazy this was etc. This has the potential > of uncertainty in the eyes of my patient. Actually, that is a wonderful point- the AMA MD's stick together- one never criticizes another doctor, without risking exile. We should decide as a profession if we agree with that ethos. Unfortunately, there is so much plurality in CM, that it is unlikely we'd all be able to agree on much of anything. We could all agree, however, to give other CM docs the benefit of the doubt. That may be neccesary for our survival. That addresses credibility in the eyes of the patient/public, but sidesteps other issues, such as quality care, safety, and how to determine when a CM doc is out of line. Since we don't have a standard of care in place to the degree that WM does, and we rely on national or state lic boards for discipline, diagnoses and treatments don't get reviewed by a third party, do they? Even if they did, could we make any judgements about right and wrong? There are many more " right " answers in CM, or such is the assumption. I think there's more here, but moving on... > Point being, if bold statements are going to be made, I think one > should be an expert (years of experience) or at least check all the > sources in the language. It goes along with the whole > discussion, " How are we going to present ourselves to the public " > etc... The internet as great as it is, can allow anyone to say > anything, including my own babble right here. But we should all be > careful. I started writing to the public more than 4 years ago. Even with one year in school, I could see plenty of basics we'd learned about which they had no idea. And still, 99% (guessing) of America has no idea that acupuncture is only one treatment modality, that Chinese herbs are based in a system of medicine, that Chinese medicine is a separate and equally valid medical system. I've made hardly a dent. It's going to take a long time. To that end, I am writing a book (I can hear the gasps already), and have a literary agent looking into publishers right now. I haven't seen much interest from other CM professionals in writing to the public. Most of them prefer to keep it " in house " in discussions like these, or trade journals, and all of that serves its own purpose, but it's light-years from the reality of patients. Unless you're going to spend 4 years educating each member of the public about CM, you have to talk to them differently. I think my 4 years of writing to the public, hearing their concerns, and answering their questions has resulted in its own specialized skill-set. As has been pointed out here and in other groups, we can't keep our heads in the sand if we want professional autonomy, respect, and equality with other medicines. We have to engage in politics, law, and education. Patient education is a vast frontier. I'd say it's relatively uncharted here in America. For example, how do we (or DO we) explain qi, what with all the controversy about its proper translation and meaning? Throughout Oriental Medicine, there are many questions, many gray areas, and much disagreement amongst experts. How do we solve that? Or, if plurality is ok, how do we present it? I do not believe that years of experience (at what, by the way? practice? scholarship?) is the key to patient education. A Japanese acupuncturist with years of experience, a Chinese-translating herbalist with years of experience, and an acupuncturist educated 15 years ago who hasn't kept up with new literature and translations but has years of experience practicing on patients may all totally disagree on what Chinese medicine is, how it should be practiced, how it should be presented to patients, let alone the fine points and details of discussions such as one herb formula in one situation. There is a lot of diversity to convey. Years of experience in one area do not translate to expertise in conveying the breadth and depth of Oriental Medicine. In fact, years of experience in one area may actually bias and hinder one from dealing fairly with plurality. Clear statements sound bold. When there is a lack of clarity, we include many " if...then " s and qualifications, etc. And we show that we don't really know. E.g. YNBY pre-surgery. We really don't know. Ok, then let's err on the side of caution. It's nice to have a conclusion. Readers like that. Writing for the public is requires with not only scholarship, authenticity, and accuracy, but also clarity, entertainment, and interest. All that said, I agree, we should be careful in what we say to the public. And, I admit that at times I get impatient and take the lone ranger approach. But, the PULSE is an open forum. I've always invited anyone who wanted to write to the public to submit articles. Few people do. Few have the passion and patience to write to patients, which is ok, everyone's different... But, if you don't want to write, to contribute to the effort, then feel free to " peer-review " the articles, especially in reference to the sources you have available to you. I'd be happy to create an official " peer-review " board, if people are actually willing to engage in that process... it doesn't pay anything, and articles would have to be reviewed in a timely manner. Let me know if anyone's interested. But don't tell me to stop writing to them just because you disagree with one point in one article, or because you own a book that I don't! Criticism is useful to a point, but can also be crippling and divisive. Ever heard that statement, " Perfectionism leads to procrastination, leads to paralysis, " or the " Paralysis of analysis " ? I'm a firm believer in making progress as an imperfect human being. And I ain't stopping. All the best, B Brian Benjamin Carter, M.Sci., L.Ac. http://www.pulsemed.org/briancarterbio.htm Acupuncturist & Herbalist Editor, The Pulse of Oriental Medicine Columnist, Acupuncture Today (619) 208-1432 San Diego (866) 206-9069 x 5284 Tollfree Voicemail The PULSE of Oriental Medicine http://www.pulsemed.org/ The General Public's Guide to Chinese Medicine since 1999... 9 Experts, 240+ Articles, 195,000+ readers.... Our free e-zine BEING WELL keeps you up to date Sign up NOW. Send a blank email to: beingwellnewsletter- Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 7, 2003 Report Share Posted June 7, 2003 , " Brian Carter " <bbcarter@p...> wrote: > > I'd be happy to do that if I had all the books. At this time, I do not own > a complete library. For example, I'd love to have the $170 pharmacology of > herbs by kee huang, but I can't afford it. Nor does PCOM have it, nor can I > get them to buy it. However, it you would like to complete my library, I'd > be happy to accept donations ;-) In a perfect world, I would be able to > write the perfect article before you saw it. But in the real world, we all > need help, such as the input you are providing. Thanks! and thus the reason for the existence of CHA is underscored again. I started this organization exactly because my own library was inadequate at the time, my experience was more limited and I did not have access to chinese language materials. I wanted to use the internet to reach out to others in the field who could help me fill holes in my knowledge while I built my library, got more experience and figured out how to access chinese source material (the last one admittedly a long time coming). Now with 800 members around the world, some with decades of clinical experience, others who read chinese fluently, researchers, product developers, biochemists, veterinarians, nurses, NDs, DCs, philosophers, linguists, publishers, editors, writers, teachers, etc., I do feel like I have that access. My thoughts on many subjects have been influenced by the debates here. sometimes subtly, sometimes moreso, sometimes in the opposite direction intended by other members. and there's only more to come. :-) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 8, 2003 Report Share Posted June 8, 2003 > > and thus the reason for the existence of CHA is underscored again. I started > this organization exactly because my own library was inadequate at the time, > my experience was more limited and I did not have access to chinese language > materials. I wanted to use the internet to reach out to others in the field who > could help me fill holes in my knowledge while I built my library, got more > experience and figured out how to access chinese source material (the last one > admittedly a long time coming). Now with 800 members around the world, > some with decades of clinical experience, others who read chinese fluently, > researchers, product developers, biochemists, veterinarians, nurses, NDs, DCs, > philosophers, linguists, publishers, editors, writers, teachers, etc., I do feel like > I have that access. My thoughts on many subjects have been influenced by > the debates here. sometimes subtly, sometimes moreso, sometimes in the > opposite direction intended by other members. and there's only more to come. > :-) The convergence of people in this group continues to astonish me. I want to thank you, again, for your seemingly tireless efforts to keep this forum vital. The exchange of viewpoints that takes place here is an essential part of the growth and development of the ideas that continue to constitute the actual foundations of the subject. Ken Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 8, 2003 Report Share Posted June 8, 2003 At 12:43 PM -0700 6/6/03, Brian Carter wrote: Actually, that is a wonderful point- the AMA MD's stick together- one never criticizes another doctor, without risking exile. We should decide as a profession if we agree with that ethos. -- Try reading the letters columns of JAMA, NEJM, and Lancet. I'd say that the level of criticism amongst MDs was robust and continuous. Rory -- Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 10, 2003 Report Share Posted June 10, 2003 While I appreciate some people's heart-felt desire to spread the " good news " of acupuncture and Chinese medicine, having made the mistake myself of writing and publishing about Chinese medicine too soon in my career and education, I can tell you how deleterious it is to the profession to prematurely attempt to write (either for the profession or for the public). Because the profession as whole has a less than scholarly relationship with reading, writing, and words in general, many members of the profession are easily influenced by things they see in print, even those things meant for lay readers. When a person writes before their " wine has matured, " they may be putting into print erroneous ideas that then become rooted in the " common wisdom " of patients and practitioners alike. Ken has touted Unschuld's new book as a possible remedy for some of the widely held myths about Chinese medicine. But how where these myths established in the first place? By well intentioned writers who did not truly know what they were writing about. I very much cop to having made this mistake myself. By attempting to write about Chinese medicine too soon in my career, I am responsible for a number of erroneous notions that come back to haunt me on an almost daily basis (since so many of them pop up here on the CHA forum). It's like the introduction of a foreign species which then becomes a weed that is almost impossible to root out and eradicate once it's taken hold. Many years ago, I was taught that the benefit of a teacher is to teach you how not to make the same mistakes others have made before. The teacher is supposed to be a guide who has traveled the path ahead of you and knows from first-hand experience the wrong turns and pit-falls up ahead. Having made this mistake myself and learned through hard experience, I sincerely caution other young practitioners not to attempt to write about Chinese medicine for publication too soon. Not only will it cause you grief personally, it may have deleterious effects on the very profession you are attempting to serve. So then, the question is how soon is too soon, and that's a hard question to answer. It depends in part on how good your source materials are. Those people who have direct and immediate access (via reading Chinese) to the whole Chinese medical literature are in a very different situation from those people who only have access to English language sources which can be characterized as second-hand hearsay. Especially if people are merely translating from Chinese, I think they can feel comfortable about publishing their translations fairly soon in their career, given that someone with more experience is there to edit and check their translations. For those without such first-hand access, I think one should have at least five years clinical experience. Even then, clinical experience alone does not make one an authority about Chinese medicine. Unfortunately, given the nature of acupuncture, one can be very poorly educated in CM and still get good enough clinical outcomes to stay in business for five, 10, or more years. Nevertheless, clinical experience is a necessary component to really understanding this medicine. As Farquhar has well pointed out in her book, Knowing Practice, true knowledge of CM is attained by a combination of theoretical education plus clinical experience. Either alone are insufficient. Fine wines, good cheeses, and great steaks are all aged before they're ready to serve up to consumers. I heartily advise even practitioners who are or have been professional writers not to engage too soon in the writing about Chinese medicine for publication. Even five years make a huge difference in my experience. Now, if Bob Felt would only let Prince Wen Hui's Cook go out of print, I might be able to sleep better at night. Let me tell, once you put something in print, it may be hell to pay to get it back out of print and out of people's minds. Bob Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 10, 2003 Report Share Posted June 10, 2003 Bob, Thank you for your thought provoking post. I am one of those members of the profession who is easily influenced by what I read in print. And having read what you just wrote, I feel compelled to respond to a couple of points. In general, I think your words of caution and restraint are much needed (if little heeded) advice for many of us who write about the subject. I find that notions of freedom and restraint are among several critical issues that underlie common misunderstandings on the part of students of Chinese medicine. I won't go into that at length, because it is another subject. But there are a couple of specific things you said that I want to ask you...and others about more closely. Ken has touted Unschuld's new book > as a possible remedy for some of the widely held myths about Chinese > medicine. But how where these myths established in the first place? By > well intentioned writers who did not truly know what they were writing > about. Writers who begin to write when they are mere novices do take this risk of writing about things that they do not deeply understand. But I think when all is said and done, for a writer there is no way around growing up in public...other than not to publish. I do not see the issue as " well intentioned " versus truly knowing what one is writing about. I see the pivotal issues as pretense. Not knowing is one thing, and it is an unavoidable and inescapable consequence of the desire to learn. In fact, I believe that it is a prerequisite for a student...or a writer to recognize clearly the known and the unknown in order to sort data and information into useful patterns. I trace the deleterious effects of some of the early texts in the English language on the subject of Chinese medicine to the pretense that surrounds the authority of those who wrote them. Even rank beginners can be honest about their study, training, and qualifications if only they desire to be. The profession underwent a protracted period characterized by people manufacturing extensive pretexts to serve as authority in a subject that more or less did not exist in the English language just a few decades ago. To some extent the recent threads on this list concerning the latest in post-nomial nomenclature, to DAOM or not to DAOM, reflect the enduring influences of this phase of Chinese medicine's development and reveal the fact that many remain more concerned with how they appear than what they truly know. Isn't there a close relationship between the appearance and meaning of the letters that come after a professional's name and the literature (as well as the knowledge that literature constitutes) that a professional is presumed to have mastered in order to bear his or her various titles? > > I very much cop to having made this mistake myself. By attempting to > write about Chinese medicine too soon in my career, I am responsible > for a number of erroneous notions that come back to haunt me on an > almost daily basis (since so many of them pop up here on the CHA > forum). It's like the introduction of a foreign species which then > becomes a weed that is almost impossible to root out and eradicate > once it's taken hold. Yes. But it is also one of the mechanisms by which cross fertilization and hybridization of ideas takes place, and this is a necessary aspect of the acculturation of those ideas, along with with the methods and techniques that they give rise to. This is bound to happen and probably must happen if the root is to flourish in new soil. [...] Even then, clinical experience > alone does not make one an authority about Chinese medicine. Here, I think you touch on the gist of the matter. Authority. What consitutues true authority in Chinese medicine? > Unfortunately, given the nature of acupuncture, one can be very poorly > educated in CM and still get good enough clinical outcomes to stay in > business for five, 10, or more years. Nevertheless, clinical > experience is a necessary component to really understanding this > medicine. As Farquhar has well pointed out in her book, Knowing > Practice, true knowledge of CM is attained by a combination of > theoretical education plus clinical experience. Either alone are > insufficient. In reading Unschuld's book, I find myself chewing on an idea that is closely related to what you've said here. Is it also necessary for one to have a personal practice related to the cultivation and care of qi in order to be well, or let's just say truly educated in Chinese medicine? > > Fine wines, good cheeses, and great steaks are all aged before they're > ready to serve up to consumers. I heartily advise even practitioners > who are or have been professional writers not to engage too soon in > the writing about Chinese medicine for publication. Even five years > make a huge difference in my experience. Even five minutes...or five heartbeats can change the way I look at things entirely. Again, I would place the emphasis on honesty and integrity rather than merely on the passage of time. The market has a perfectly functional remedy for inferior products. What we need to be vigilant about is not that young or inexperienced individuals might produce such products but that no one be permitted to construct invalid foundations in order to pretend authority. And when you come right down to it, isn't this first, last and always simply a matter of individual integrity? Now, if Bob Felt would only > let Prince Wen Hui's Cook go out of print, I might be able to sleep > better at night. Let me tell, once you put something in print, it may > be hell to pay to get it back out of print and out of people's minds. > Well, Bob's a merchant, and even his dedication to the subject is predicated on his having products to sell. So it seems to me that the only way to drive one product from the market is to replace it with a better one that will make use of the market mechanisms involved. I don't mean to be giving you a hard time about any of this. As I said at the top, I basically agree with what you've said. But as an editor, I find myself constantly face to face with certain stark facts. And certain stark fact number one is that there remains a galling dearth of good writing on the subject...particularly compared to the vast extent of the subject itself. So along with providing other writers with very necessary cautions about leaping before they look, I want to encourage people to committ their thoughts to words and exchange them freely and openly. Our mutual friend Gerd Ohmstede recently asked me about what makes this list tick. And I told him that the number one issue in my view is Todd's persistence at maintaining the integrity of the forum itself. The existence of the forum reflects people's fundamental need to be able to forumulate their thoughts in words and exchange them with one another. As a writer, I always try to bear in mind when doing my work, that that is really all there is to it. And to the extent that this sort of exchange flourishes, I believe we can contend with the strains and pressures involved with growing up, both as individuals and as a profession, in plain public view. Ken Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 10, 2003 Report Share Posted June 10, 2003 Ken, I like your response very much. Perhaps the real issue IS honesty and disclosure. For sure, everyone makes mistakes and everyone is constantly growing. Nor would I like to see dissent and discussion stifled. I do not think CM is a fait accompli but rather a continuously evolving body of thought and practice. But let me ask you, as editor of a professional journal, don't you (or your peer review committee) have to sometimes make judgements on pieces submitted for publication? What if a piece is poorly researched or poorly thought-out? My guess is that you reject it (with or without suggestions for improvement). Unfortunately, not all CM publishing venues are peer-reviewed or even have a mature, professional editor at the helm. And many of those less professional venues are also crying for anything to publish and fill their pages. So, caveat emptor? Ultimately, I guess that's what it comes down to. However, based on my own experience, I would still counsel young practitioners to think twice before they rush to publish. One solution is to ask an older, more knowledgeable practitioner to be one's mentor or unofficial editor. I know I do this for several younger practitioners. Bob Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 10, 2003 Report Share Posted June 10, 2003 In a message dated 6/10/03 9:11:46 PM, marnae writes: <<Fine wines, good cheeses, and great steaks are all aged before they're ready to serve up to consumers. I heartily advise even practitioners who are or have been professional writers not to engage too soon in the writing about Chinese medicine for publication.>> I think it is also important to confirm that even what the best intentioned neutral interpreter or philosopher says is slanted by the filters of that persons life, and that ones clinical experience is the same. All we can do is our best to get our patients on the road to wellness and the best way we can find is one where we don't believe, like Crazy Miranda (and old Jef Airplane number), in everything we read until we see it and it makes sense from our personal experience. <<I hope that at some point our schools mature to the point where the process of working with individual students and the time that that requires is recognized as a value to the institution and is recompensed appropriately. Otherwise, those of us who do it anyway start to get burned out.>> I also think it is time we started to move away from being vocational schools and into being colleges of higher learning. I tend to be on the more political front, although I, like most fools, try to keep my fingers in many pies. One of the problems I see is that many of the OM compatriots in our field are not very literate nor conversant when it comes time to blend with politicans and other actors who are somewhat educated. Indeed, they do not seem to see a need to advance our profession politically as well as academically, if at all beecause they are "not political". This foolish "head in the sand" attitude may be our undoing as we lose ground in many states and don't advance in others because of an absence of people who look to the future in our chosen profession. Just an opinion, but one that needs to be expressed, especially among herbalists. David Molony Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 10, 2003 Report Share Posted June 10, 2003 Again, well put Bob!! marnae At 04:38 PM 6/10/2003 +0000, you wrote: While I appreciate some people's heart-felt desire to spread the " good news " of acupuncture and Chinese medicine, having made the mistake myself of writing and publishing about Chinese medicine too soon in my career and education, I can tell you how deleterious it is to the profession to prematurely attempt to write (either for the profession or for the public). Because the profession as whole has a less than scholarly relationship with reading, writing, and words in general, many members of the profession are easily influenced by things they see in print, even those things meant for lay readers. When a person writes before their " wine has matured, " they may be putting into print erroneous ideas that then become rooted in the " common wisdom " of patients and practitioners alike. Ken has touted Unschuld's new book as a possible remedy for some of the widely held myths about Chinese medicine. But how where these myths established in the first place? By well intentioned writers who did not truly know what they were writing about. I very much cop to having made this mistake myself. By attempting to write about Chinese medicine too soon in my career, I am responsible for a number of erroneous notions that come back to haunt me on an almost daily basis (since so many of them pop up here on the CHA forum). It's like the introduction of a foreign species which then becomes a weed that is almost impossible to root out and eradicate once it's taken hold. Many years ago, I was taught that the benefit of a teacher is to teach you how not to make the same mistakes others have made before. The teacher is supposed to be a guide who has traveled the path ahead of you and knows from first-hand experience the wrong turns and pit-falls up ahead. Having made this mistake myself and learned through hard experience, I sincerely caution other young practitioners not to attempt to write about Chinese medicine for publication too soon. Not only will it cause you grief personally, it may have deleterious effects on the very profession you are attempting to serve. So then, the question is how soon is too soon, and that's a hard question to answer. It depends in part on how good your source materials are. Those people who have direct and immediate access (via reading Chinese) to the whole Chinese medical literature are in a very different situation from those people who only have access to English language sources which can be characterized as second-hand hearsay. Especially if people are merely translating from Chinese, I think they can feel comfortable about publishing their translations fairly soon in their career, given that someone with more experience is there to edit and check their translations. For those without such first-hand access, I think one should have at least five years clinical experience. Even then, clinical experience alone does not make one an authority about Chinese medicine. Unfortunately, given the nature of acupuncture, one can be very poorly educated in CM and still get good enough clinical outcomes to stay in business for five, 10, or more years. Nevertheless, clinical experience is a necessary component to really understanding this medicine. As Farquhar has well pointed out in her book, Knowing Practice, true knowledge of CM is attained by a combination of theoretical education plus clinical experience. Either alone are insufficient. Fine wines, good cheeses, and great steaks are all aged before they're ready to serve up to consumers. I heartily advise even practitioners who are or have been professional writers not to engage too soon in the writing about Chinese medicine for publication. Even five years make a huge difference in my experience. Now, if Bob Felt would only let Prince Wen Hui's Cook go out of print, I might be able to sleep better at night. Let me tell, once you put something in print, it may be hell to pay to get it back out of print and out of people's minds. Bob Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 10, 2003 Report Share Posted June 10, 2003 Ken, Bob etc. Like Ken, I agree with most of Bob's recent post. However, as you say, there is a dearth of writing in this field. Unfortunately, I believe that the reason for this goes back to the schools, again! I recently (no longer) worked at a school that had a Master's thesis requirement. There were several problems with the requirement: First, the school did not support the faculty in giving guidance to the students nor did the school support the process of learning to write. At traditional academic institutions, one part of a full-time faculty load is being a thesis advisor - in exchange, faculty teach one or two classes per term. At most of our schools, if there are full-time faculty, they teach 3 - 5 classes per term, have an administrative responsibility and are also expected to mentor students. This ends up being an almost impossible task. And so, unfortunatly, the mentoring of individual student work often gets put to the side. As a full-time faculty who had some writing experience and an advanced degree from a traditional academic institution, I found myself mentoring between 6 - 10 students per semester. Because the program did not support the thesis process for the students, many of them had never even written a 10 page research paper, much less a 30 - 50 page thesis (and these were not clinically based but literature based). I often spent more of my time simply correcting spelling and grammatical problems than I did working with the content of the thesis. From my perspective, a Master's thesis should generate several publishable articles. Very few of the theses that I read were up to the standard of publication and, again, because the school did not support the process I was unable to give the time to the students to help them to achieve that - and so, the theses sit in the school library and never get looked at or worked on again. I relate this experience because it is a problem for this field. Our students are not trained to write well and as a result, do not write after completing their education. I recently had a conversation with a colleague who actually did write a good thesis and suggested to her that she consider publication. She was shocked that this might even be a possibility. The sense that we are training clinicians only seems to pervade our profession when in fact we should be training individuals who are clinicians but who also can think and reason and write and express themselves in public. It takes a certain amount of ego to be willing to put yourself out there in a publication and to deal with the critique that comes from that. Here we are back to authority and ownership - many of our students and professionals do not feel a sense of ownership of their medicine and so do not write. In traditional academia and in medicine, writing is how we communicate what we are doing with our colleagues - it is a conversation over many years that allows the participants to grow from the critiques and to mature their ideas. I believe that as educators we need to help our students to develop this way of thinking rather than being afraid to say something publicly. I am always encouraging students to read and write - papers, case studies, theoretical treatises, just random thoughts. I hope that at some point our schools mature to the point where the process of working with individual students and the time that that requires is recognized as a value to the institution and is recompensed appropriately. Otherwise, those of us who do it anyway start to get burned out. Marnae At 09:31 PM 6/10/2003 +0000, you wrote: Bob, Thank you for your thought provoking post. I am one of those members of the profession who is easily influenced by what I read in print. And having read what you just wrote, I feel compelled to respond to a couple of points. In general, I think your words of caution and restraint are much needed (if little heeded) advice for many of us who write about the subject. I find that notions of freedom and restraint are among several critical issues that underlie common misunderstandings on the part of students of Chinese medicine. I won't go into that at length, because it is another subject. But there are a couple of specific things you said that I want to ask you...and others about more closely. Ken has touted Unschuld's new book > as a possible remedy for some of the widely held myths about Chinese > medicine. But how where these myths established in the first place? By > well intentioned writers who did not truly know what they were writing > about. Writers who begin to write when they are mere novices do take this risk of writing about things that they do not deeply understand. But I think when all is said and done, for a writer there is no way around growing up in public...other than not to publish. I do not see the issue as " well intentioned " versus truly knowing what one is writing about. I see the pivotal issues as pretense. Not knowing is one thing, and it is an unavoidable and inescapable consequence of the desire to learn. In fact, I believe that it is a prerequisite for a student...or a writer to recognize clearly the known and the unknown in order to sort data and information into useful patterns. I trace the deleterious effects of some of the early texts in the English language on the subject of Chinese medicine to the pretense that surrounds the authority of those who wrote them. Even rank beginners can be honest about their study, training, and qualifications if only they desire to be. The profession underwent a protracted period characterized by people manufacturing extensive pretexts to serve as authority in a subject that more or less did not exist in the English language just a few decades ago. To some extent the recent threads on this list concerning the latest in post-nomial nomenclature, to DAOM or not to DAOM, reflect the enduring influences of this phase of Chinese medicine's development and reveal the fact that many remain more concerned with how they appear than what they truly know. Isn't there a close relationship between the appearance and meaning of the letters that come after a professional's name and the literature (as well as the knowledge that literature constitutes) that a professional is presumed to have mastered in order to bear his or her various titles? > > I very much cop to having made this mistake myself. By attempting to > write about Chinese medicine too soon in my career, I am responsible > for a number of erroneous notions that come back to haunt me on an > almost daily basis (since so many of them pop up here on the CHA > forum). It's like the introduction of a foreign species which then > becomes a weed that is almost impossible to root out and eradicate > once it's taken hold. Yes. But it is also one of the mechanisms by which cross fertilization and hybridization of ideas takes place, and this is a necessary aspect of the acculturation of those ideas, along with with the methods and techniques that they give rise to. This is bound to happen and probably must happen if the root is to flourish in new soil. [...] Even then, clinical experience > alone does not make one an authority about Chinese medicine. Here, I think you touch on the gist of the matter. Authority. What consitutues true authority in Chinese medicine? > Unfortunately, given the nature of acupuncture, one can be very poorly > educated in CM and still get good enough clinical outcomes to stay in > business for five, 10, or more years. Nevertheless, clinical > experience is a necessary component to really understanding this > medicine. As Farquhar has well pointed out in her book, Knowing > Practice, true knowledge of CM is attained by a combination of > theoretical education plus clinical experience. Either alone are > insufficient. In reading Unschuld's book, I find myself chewing on an idea that is closely related to what you've said here. Is it also necessary for one to have a personal practice related to the cultivation and care of qi in order to be well, or let's just say truly educated in Chinese medicine? > > Fine wines, good cheeses, and great steaks are all aged before they're > ready to serve up to consumers. I heartily advise even practitioners > who are or have been professional writers not to engage too soon in > the writing about Chinese medicine for publication. Even five years > make a huge difference in my experience. Even five minutes...or five heartbeats can change the way I look at things entirely. Again, I would place the emphasis on honesty and integrity rather than merely on the passage of time. The market has a perfectly functional remedy for inferior products. What we need to be vigilant about is not that young or inexperienced individuals might produce such products but that no one be permitted to construct invalid foundations in order to pretend authority. And when you come right down to it, isn't this first, last and always simply a matter of individual integrity? Now, if Bob Felt would only > let Prince Wen Hui's Cook go out of print, I might be able to sleep > better at night. Let me tell, once you put something in print, it may > be hell to pay to get it back out of print and out of people's minds. > Well, Bob's a merchant, and even his dedication to the subject is predicated on his having products to sell. So it seems to me that the only way to drive one product from the market is to replace it with a better one that will make use of the market mechanisms involved. I don't mean to be giving you a hard time about any of this. As I said at the top, I basically agree with what you've said. But as an editor, I find myself constantly face to face with certain stark facts. And certain stark fact number one is that there remains a galling dearth of good writing on the subject...particularly compared to the vast extent of the subject itself. So along with providing other writers with very necessary cautions about leaping before they look, I want to encourage people to committ their thoughts to words and exchange them freely and openly. Our mutual friend Gerd Ohmstede recently asked me about what makes this list tick. And I told him that the number one issue in my view is Todd's persistence at maintaining the integrity of the forum itself. The existence of the forum reflects people's fundamental need to be able to forumulate their thoughts in words and exchange them with one another. As a writer, I always try to bear in mind when doing my work, that that is really all there is to it. And to the extent that this sort of exchange flourishes, I believe we can contend with the strains and pressures involved with growing up, both as individuals and as a profession, in plain public view. Ken Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 11, 2003 Report Share Posted June 11, 2003 , acuman1@a... wrote: One of the problems I see is that many of the OM compatriots in our field are not very literate nor conversant when it comes time to blend with politicans and other actors who are somewhat educated. Indeed, they do not seem to see a need to advance our profession politically as well as academically, if at all beecause they are " not political " . This foolish " head in the sand " attitude may be our undoing as we lose ground in many states and don't advance in others because of an absence of people who look to the future in our chosen profession. >>> David: Is there a forum like this one to promote discussion, activism, and keep people up-to-date on the political goings on? Jim Ramholz Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 11, 2003 Report Share Posted June 11, 2003 Bob, , " Bob Flaws " <pemachophel2001> wrote: > Ken, > > I like your response very much. Darn. I hope we don't give anyone the impression that we agree...about anything... Perhaps the real issue IS honesty and > disclosure. For sure, everyone makes mistakes and everyone is > constantly growing. Nor would I like to see dissent and discussion > stifled. I do not think CM is a fait accompli but rather a > continuously evolving body of thought and practice. I heard someone once describe Stanley Kubrick's desk as a small black hole, and that is more or less how I think of Chinese medicine. A singular confusion made up of a vast complexity of ponderous objects, which can fit in a relatively small building... ....at least to house the documentation for the software that runs the " system " we call Chinese medicine. I would certainly never want to see dissent and discussion stifled in any slightest way. As I've said before, the opposition of ideas is not just mandatory for the healthy growth and development of the subject, it is true friendship. > > But let me ask you, as editor of a professional journal, don't you (or > your peer review committee) have to sometimes make judgements on > pieces submitted for publication? What if a piece is poorly researched > or poorly thought-out? My guess is that you reject it (with or without > suggestions for improvement). Cai dui le! The rejection pile ought to be a measure of the depth of writing. Ours is not deep enough. The way to ensure great writing... to whatever extent is can be ensured... is to encourage massive amounts of production on the part of those with the need to create it and then whittle away everything that doesn't fit the standards. At CAOM we have concerned ourselves for nearly three years now with discussion of the whole standards process. Where do they come from? How do they fit and function in the process of designing good trials and the preparation and publication of reports to the profession on such research? Steve Birch has done considerable work towards developing definitions of such terms as " traditional " " traditional medicine " etc., which turn out to be enormously important when it comes to establishing real standards that people will actually use. And one of the key actions related to standards is measuring work done and rejecting that which simply does not measure up. It's inherenly elitist work and goes against the grain of the ethos of the counter culture, which is based on the idea that hard work is inimical to happiness. Which is to say that such work is thankless and not very popular. > > Unfortunately, not all CM publishing venues are peer-reviewed or even > have a mature, professional editor at the helm. And many of those less > professional venues are also crying for anything to publish and fill > their pages. So, caveat emptor? Ultimately it's caveat emptor, no matter who is reviewing what. The ultimate responsibility for what we put in our minds remains with each of us individually. Ultimately, I guess that's what it > comes down to. However, based on my own experience, I would still > counsel young practitioners to think twice before they rush to > publish. One solution is to ask an older, more knowledgeable > practitioner to be one's mentor or unofficial editor. I know I do this > for several younger practitioners. Again, I have no quarrel with such counsel and strongly encourage others accordingly. In fact, anyone who has ever asked me for such help knows that I am always willing to give it. For myself, I find little of greater value as a writer than someone who is willing to deconstruct or at least tear apart something I have written. So I try to give as much of this sort of thing as I can as a way of making deposits in my karmic account. Ken > > Bob Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 11, 2003 Report Share Posted June 11, 2003 Jim, > > Is there a forum like this one to promote discussion, activism, and > keep people up-to-date on the political goings on? > The media in general exist for just such a purpose. It is remarkably easy to gain access to even the most mainstream media. Having something coherent to say is far more difficult. Ken Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 11, 2003 Report Share Posted June 11, 2003 , " dragon90405 " <yulong@m...> wrote: > Bob, > > , " Bob Flaws " > <pemachophel2001> wrote: > > Ken, > > > > I like your response very much. > > Darn. I hope we don't give anyone the impression > that we agree...about anything.. yeah. its pretty scary. :-) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 11, 2003 Report Share Posted June 11, 2003 In a message dated 6/11/03 2:59:07 AM, jramholz writes: , acuman1@a... wrote: One of the problems I see is that many of the OM compatriots in our field are not very literate nor conversant when it comes time to blend with politicans and other actors who are somewhat educated. Indeed, they do not seem to see a need to advance our profession politically as well as academically, if at all beecause they are "not political". This foolish "head in the sand" attitude may be our undoing as we lose ground in many states and don't advance in others because of an absence of people who look to the future in our chosen profession. >>> David: Is there a forum like this one to promote discussion, activism, and keep people up-to-date on the political goings on? Jim Ramholz When the whole is removed from the parts, neither survives or prospers. This is a discussion about academia, and it is my posit that when deciding educational values and the relative lack of a rounded education within our profession, politics is indeed involved. I suspect any ancient Chinese scholar would agree with that since history, art, music, literature, and medicine are intertwined in education. I read this forum regularly, and do not insert my views on politics, or other things, where they are not indicated. However, taken in the discussion here about the doctoral level of education and comparing i it to todays master's, with all of its implications, the part of my post that relates to politics is indeed indicated. The essence of my point is that the same absence of a complete education that leads to poor writing skills also leads to poor political understanding, interest, and capability. That said, I will not darken the door of this discussion further with the reality that politics may indeed play at least a part in the future of our field as might poor writing, but that reality may not be what you are interested in including in the discussion, despite history. I can live with that. David Molony Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 11, 2003 Report Share Posted June 11, 2003 Marnae, I agree about the lack of true support for Masters level academics at many (if not most) of our schools. I question whether a good percentage of our teachers could even produce a real Masters thesis. Isn't a large part of this problem also that the schools do not limit their enrollment to truly Masters quality students? In my experience teaching around the U.S., approximately half of the student body is made up of people who probably should not try to be more than massage therapists as opposed to doctors of CM. Bob Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 11, 2003 Report Share Posted June 11, 2003 , " dragon90405 " wrote: > The media in general exist for just such > a purpose. It is remarkably easy to gain > access to even the most mainstream media. > Having something coherent to say is far > more difficult. >>> Ken: Perhaps I should have made myself more clear. I was wondering about forums of the national organizations and their activities; that's why I was addressing it to David. Jim Ramholz Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 11, 2003 Report Share Posted June 11, 2003 Jim, > > Perhaps I should have made myself more clear. I was wondering about > forums of the national organizations and their activities; that's > why I was addressing it to David. > You were already clear. The point I was making was just that if anyone wants to take the discussion of issues relating to the public to the public media, it is a relatively easy task. In fact, I think that the public is quite interested in many of these issues and that media outlets are hungry for such content. So what I meant to say is that the " forum " exists. Ken Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 11, 2003 Report Share Posted June 11, 2003 Again, I have to agree as well (yikes). Many (if not most) of the students in these programs meet only the minimal requirements of 2years of college and have never written a paper or read a paper critically before. This is very unfortunate, but, as we are market driven, for the time being we work around these minimal standards. Writing is one of those areas that so far has also been ignored in the doctoral programs. Because they are " clinical doctorates " there is not necessarily a final written piece - again we are producing clinicians who cannot write about what they do. This is very unfortunate and a reason to think about a Ph.D in the field as another, entirely different degree. Marnae At 02:45 PM 6/11/2003 +0000, you wrote: Marnae, I agree about the lack of true support for Masters level academics at many (if not most) of our schools. I question whether a good percentage of our teachers could even produce a real Masters thesis. Isn't a large part of this problem also that the schools do not limit their enrollment to truly Masters quality students? In my experience teaching around the U.S., approximately half of the student body is made up of people who probably should not try to be more than massage therapists as opposed to doctors of CM. Bob Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 11, 2003 Report Share Posted June 11, 2003 Marnae, Bob, and all, > Again, I have to agree as well (yikes). Many (if not most) of the > students in these programs meet only the minimal requirements of 2years of > college and have never written a paper or read a paper critically > before. This is very unfortunate, but, as we are market driven, for the > time being we work around these minimal standards. Writing is one of those > areas that so far has also been ignored in the doctoral programs. Because > they are " clinical doctorates " there is not necessarily a final written > piece - again we are producing clinicians who cannot write about what they > do. This is very unfortunate and a reason to think about a Ph.D in the > field as another, entirely different degree. > Accepting the point that's been made here that the prerequisites are lacking, wouldn't it make sense to focus the discussion on programs to get the missing basics in as a forestep to designing additional advanced degrees? Ken Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 11, 2003 Report Share Posted June 11, 2003 Accepting the point that's been made here that the prerequisites are lacking, wouldn't it make sense to focus the discussion on programs to get the missing basics in as a forestep to designing additional advanced degrees? Agreed - and this is something that some of the programs are working on - we start students writing from their first theory course and it continues every semester. Research papers, case studies, opinion pieces etc. But, because of the nature of the clinical doctorate, if they really want to continue in a more academic path, there is no place to go for a higher degree. The DAOM is not an academic degree, language study is not a requirement, writing is not a requirement etc. In traditional academe, we learn to write, critique and teach as we get our degree - that is a part of the degree process. Obviously to get into these programs one must already be able to write to a certain level, but the transition that occurs between undergraduate and graduate level writing is quite remarkable. In a sense, our Master's programs often need to remediate poor high school and college training but then there is little place to go with it except into the clinical doctorate. So, again, we are creating " doctors " out of clinicians who cannot write but we have little room for academics who are also clinicians. marnae At 01:42 AM 6/12/2003 +0000, you wrote: Marnae, Bob, and all, > Again, I have to agree as well (yikes). Many (if not most) of the > students in these programs meet only the minimal requirements of 2years of > college and have never written a paper or read a paper critically > before. This is very unfortunate, but, as we are market driven, for the > time being we work around these minimal standards. Writing is one of those > areas that so far has also been ignored in the doctoral programs. Because > they are " clinical doctorates " there is not necessarily a final written > piece - again we are producing clinicians who cannot write about what they > do. This is very unfortunate and a reason to think about a Ph.D in the > field as another, entirely different degree. > Ken Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 12, 2003 Report Share Posted June 12, 2003 In looking at a PA Medical board agenda, it looks as if we are not the only ones discussing educaton and professionalism amongst our fellows. REPORT OF COMMITTEE ON MEDICAL EDUCATION (Daniel B. Kimball, Jr., M.D.) 1) Embedding Professionalism in Medical Education………………………………342 (Kimball, by the way, was the main author for the medical board federation's guide for alternative medicine practices.) David Molony Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 13, 2003 Report Share Posted June 13, 2003 In a message dated 6/11/03 9:36:20 PM, marnae writes: Because they are "clinical doctorates" there is not necessarily a final written piece - again we are producing clinicians who cannot write about what they do. This is very unfortunate and a reason to think about a Ph.D in the field as another, entirely different degree. Marnae While I see many MD's with poor writing skills and consider clinical and writing (not reading) skills different, I must admit that we do need PhD's in OM and look forward to that being the next hurdle after th eoriginal clinical doctorate, which we should have had years ago and be building upon (like other medical professions have) instead of building up to it in such a haphazard fashion. David Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.